Abstract & Overview
Introduction. The hemostatic system plays an important role in exacerbating the pathogenic processes of acute pancreatitis and the development of complications, but it is still insufficiently studied. The aim of the study is to explore the pathogenic relationship between oxidative stress and the coagulation system in patients with acute pancreatitis. Materials and methods. Fifty patients with acute pancreatitis were studied and divided into two groups: the first group (n = 24) had a mild form of the disease, and the second group (n = 26) had a severe form. To determine the relationship between hemostatic disorders and oxidative stress, an assessment of endotoxicosis, lipid peroxidation activity, and the functional state of the hemostatic system was conducted in the patients. Results. In the studied patients, early in the hospitalization period, the development of endogenous intoxication was noted (an increase in the toxicity index in the plasma of both patient groups), as well as intensification of lipid peroxidation (an elevation in the level of diene conjugates in both groups). Analysis of the coagulation system revealed hypercoagulation (shortened reactive time) and hypofibrinolysis (prolonged clot lysis time). Discussion and conclusion. The development of early oxidative stress against the backdrop of endotoxicosis in acute pancreatitis leads to the activation of transcription factors, an imbalance in the cytokine system, disturbances in the coagulation-fibrinolytic system, deposition of (micro)vascular thrombi, tissue ischemia, and organ dysfunction. In the presence of oxidative stress, the pathological progression of the disease is exacerbated through disruptions in the hemostatic system, resulting in a more severe course of the disease. The identified changes may be useful for adjusting the therapy of patients with acute pancreatitis.